The charlotte large artery occlusion endovascular therapy outcome score compares favorably to the critical area perfusion score for prognostication before basilar thrombectomy

•The Critical Area Perfusion Score (CAPS) predicts outcome for basilar thrombectomy patients•We compared CAPS to a clinical-radiographic model called CLEOS•CLEOS performed better in our cohort overall and in patients with revascularization•Prognostic models may be used for patient selection in future basilar thrombosis trials The Critical Area Perfusion Score (CAPS) predicts functional outcomes in vertebrobasilar thrombectomy patients based on computed tomography perfusion (CTP) hypoperfusion. We compared CAPS to the clinical-radiographic Charlotte Large artery occlusion Endovascular therapy Outcome Score (CLEOS). Acute basilar thrombosis patients from January 2017–December 2021 were included in this retrospective analysis from a health system's stroke registry. Inter-rater reliability was assessed for 6 CAPS raters. A logistic regression with CAPS and CLEOS as predictors was performed to predict 90-day modified Rankin Scale (mRS) score 4-6. Area under the curve (AUC) analyses were performed to evaluate prognostic ability. 55 patients, mean age 65.8 (± 13.1) years and median NIHSS score 15.55–24, were included. Light's kappa among 6 raters for favorable versus unfavorable CAPS was 0.633 (95% CI 0.497–0.785). Increased CLEOS was associated with elevated odds of a poor outcome (odds ratio (OR) 1.0010, 95% CI 1.0007–1.0014, p